Pixee knee+ augmented reality assisted navigation for total knee arthroplasty in an ambulatory surgical center

Abstract

Total knee arthroplasty (TKA) requires precise alignment for optimal post-operative outcomes and prosthesis longevity. Recently, augmented reality (AR) has emerged as a promising technology in surgical procedures, including TKA. This case series evaluates the feasibility and accuracy of the knee+ augmented reality-assisted navigation (ARAN) system by Pixee Medical in an ambulatory surgical center (ASC) setting. Our study involved 17 consecutive TKA patients performed with the knee+ ARAN system at an ASC from August 2022 to October 2022. Demographic data, including sex, age, ASA score, height, weight, and BMI, were recorded. Postoperative measurements of the mechanical distal femoral angle (MDFA), mechanical distal tibial angle (MDTA), posterior tibial slope (PTS), femoral-tibial angle (FTA), and posterior femoral flexion (PFF) were compared to the ideal intraoperative angles. Outliers were defined as deviations greater than 3° from the planned angles. In this study, 15 out of 17 TKAs utilizing the Pixee knee+ ARAN system were analyzed. All mean post-operative radiographic measurements were within clinically acceptable ranges. The study also found that surgeries using the knee+ system had a slightly longer incision-to-closing time relative to the control group of patients undergoing normal TKA. Our results indicate clinically acceptable accuracy and precision in alignment with the knee+ ARAN system, albeit with a slight increase in surgery duration. This is the first study evaluating the knee+ ARAN system in an ASC setting indicates its suitability for outpatient centers, highlighting its precision, portability, and cost-effectiveness. Larger studies utilizing outcome measures can further assess the system’s advantages and disadvantages.